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cerumen management

Jeffrey G. Sirianni sirianni at uts.cc.utexas.edu
Thu Feb 15 22:18:45 EST 1996

In article <3120C780.3683 at cyberport.net>, Alan Sias <arsias at cyberport.net> says:
>An interesting topic.  Out of curiosity, how many of you out there are 
>doing cerumen mangement?  What do you feel about it??

Coming out of a "conservative" program, I was always tought that it is better
to refer for cerumen removal than do something you'd regret later.  Well all I
regret is having to hear this statement at all.

I have been out for about a year and remove cerumen on a daily basis.  I find
patients appreciate the sevice.  I have yet to specifically bill the service as
cerumen removal, but always bill for something, usually a hearing aid check.  I
routinely remove cerumen from patients who come in for follow-ups on their new
aids, since this reduces the chances of blockage and hence dissatisfaction.

I guess I feel comfortable based on two things.  First, I work in an ENT office
and if I encounter anything tricky, I am quick to say "Let's see the doctor about
the wax... It is too difficult for me to take out".  These are cases of deep
impactions or in children that will not sit still.  There's nothing like getting
out the water gun. :-)

Second, I have several years of experience performing surgical techniques used in
animal research, so I have no problem using small instruments like a curette.  I 
would suggest folks with shakey hands to be cautious.

I have had some patients thank me for doing the removal versus the doctor.  I
think that he sometimes hurries and causes discomfort due to rushing through it.
Take your time.  Look twice and scoop once (a take-off of my grandfather's saying
"Measure once, cut twice").  Plan an attack on the wax.  Go slow, don't try to get it
all if you are going to risk injury. 

Jeff Sirianni     @(((<{
University of Texas at Austin
Communication Sciences and Disorders
CMA, 2nd Floor Clinic
Austin, TX  78712-1089
sirianni at uts.cc.utexas.edu
jgsaudio at aol.com

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